| Doctor Name: | MRS. KELLY LYNN BROOKS |
| NPI Number: | 1366689358 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 20091 |
| Business Practice Address: | 828 Ventura St Ste 100 Fillmore, CA - 93015 |
| Business Phone Number: | 8055242000 |
| Business Fax Number: | |
| Mailing Address: | 4484 Coffeetree Ln, MOORPARK |
| State: | CA |
| Postal Code: | 930213533 |
| Phone Number: | 8055292225 |
| Fax Number: | 8055292225 |
| NPI Enumeration Date: | 01/13/2009 |
| NPI Last Update Date: | 01/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | 20091 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |